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|Title:||A clinical study on the utility of muscle biopsy in patients with suspected myopathy|
|Abstract:||Myopathy is one of the common disorders in patients attending neuromuscular clinic. Systematic approach comprising a comprehensive clinical history, thorough neurological and systemic examination, nerve conduction studies, EMG and relevant biochemical tests should be undertaken in all cases. Muscle biopsy is one of the most frequently used diagnostic procedures in the evaluation of inherited and acquired myopathies. The yield of muscle biopsy result is dependent on number of factors, including appropriate selection of patients for biopsy, expertise of the laboratory, and techniques used in the analysis. The history of muscle biopsy dates back to 1860 when Duchenne first performed a biopsy on a patient with symptoms of myopathy. Introduction of enzyme histochemical methods by Victor Dubowitz in 1970 revolutionised the role of muscle biopsy in the diagnosis of various primary and secondary muscle diseases(7). Diagnosis of various subtypes of dystrophies was further made easy with beginning of immunohistochemical methods in 1980s However, there are few modern reports documenting the diagnostic yield and clinical utility of open muscle biopsy.(1-5) Clinicians usually rely on personal experience to develop their own criteria for performing muscle biopsy. This may explain the variable diagnostic outcome of muscle biopsy found in previous cohorts which ranged from 13.2% to 59.9%.(8,9). In most of the proximal myopathies and generalised/systemic diseases; vastus lateralis is the standard muscle biopsied by international consensus. (6) The other muscles that are good choices for biopsy are biceps and gastrocnemius. However, many forms of hereditary muscle disorders can now be diagnosed with molecular genetic testing, thereby eliminating the need for performing a muscle biopsy in every patient. In this study, we evaluate the clinical utility of muscle biopsy in patients with suspected myopathy. The primary objective is to determine the diagnostic value of muscle biopsy, as measured by the probability of specific myopathy and depending on the available pre procedure clinical and laboratory data|
|Appears in Collections:||Neurology|
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